We investigated the performance of a novel HD-DOT system by replicating a series of classic visual stimulation paradigms. Haemodynamic response functions and cortical activation maps replicated the results obtained with larger fibre-based systems.
We have developed a series of wearable high-density diffuse optical tomography (HD-DOT) technologies specifically for neonatal applications. These systems provide an ultra-lightweight form factor, a low profile and high mechanical flexibility. This new technology is validated using a novel, anatomically accurate dynamic phantom.
We are translating wearable HD-DOT to the neonatal clinic to investigate healthy and brain-injured infants and establish a model of the developmental trajectory of the infant sensorimotor system.
KEYWORDS: Diffuse optical tomography, Visualization, Neurophotonics, Visual cortex, Head, Brain, Hemodynamics, 3D modeling, Signal to noise ratio, Imaging systems
Significance: High-density diffuse optical tomography (HD-DOT) has been shown to approach the resolution and localization accuracy of blood oxygen level dependent-functional magnetic resonance imaging in the adult brain by exploiting densely spaced, overlapping samples of the probed tissue volume, but the technique has to date required large and cumbersome optical fiber arrays.
Aim: To evaluate a wearable HD-DOT system that provides a comparable sampling density to large, fiber-based HD-DOT systems, but with vastly improved ergonomics.
Approach: We investigated the performance of this system by replicating a series of classic visual stimulation paradigms, carried out in one highly sampled participant during 15 sessions to assess imaging performance and repeatability.
Results: Hemodynamic response functions and cortical activation maps replicate the results obtained with larger fiber-based systems. Our results demonstrate focal activations in both oxyhemoglobin and deoxyhemoglobin with a high degree of repeatability observed across all sessions. A comparison with a simulated low-density array explicitly demonstrates the improvements in spatial localization, resolution, repeatability, and image contrast that can be obtained with this high-density technology.
Conclusions: The system offers the possibility for minimally constrained, spatially resolved functional imaging of the human brain in almost any environment and holds particular promise in enabling neuroscience applications outside of the laboratory setting. It also opens up new opportunities to investigate populations unsuited to traditional imaging technologies.
Significance: Neonates are a highly vulnerable population. The risk of brain injury is greater during the first days and weeks after birth than at any other time of life. Functional neuroimaging that can be performed longitudinally and at the cot-side has the potential to improve our understanding of the evolution of multiple forms of neurological injury over the perinatal period. However, existing technologies make it very difficult to perform repeated and/or long-duration functional neuroimaging experiments at the cot-side.
Aim: We aimed to create a modular, high-density diffuse optical tomography (HD-DOT) technology specifically for neonatal applications that is ultra-lightweight, low profile and provides high mechanical flexibility. We then sought to validate this technology using an anatomically accurate dynamic phantom.
Approach: An advanced 10-layer rigid-flexible printed circuit board technology was adopted as the basis for the DOT modules, which allows for a compact module design that also provides the flexibility needed to conform to the curved infant scalp. Two module layouts were implemented: dual-hexagon and triple-hexagon. Using in-built board-to-board connectors, the system can be configured to provide a vast range of possible layouts. Using epoxy resin, thermochromic dyes, and MRI-derived 3D-printed moulds, we constructed an electrically switchable, anatomically accurate dynamic phantom. This phantom was used to quantify the imaging performance of our flexible, modular HD-DOT system.
Results: Using one particular module configuration designed to cover the infant sensorimotor system, the device provided 36 source and 48 detector positions, and over 700 viable DOT channels per wavelength, ranging from 10 to ∼45 mm over an area of approximately 60 cm2. The total weight of this system is only 70 g. The signal changes from the dynamic phantom, while slow, closely simulated real hemodynamic response functions. Using difference images obtained from the phantom, the measured 3D localization error provided by the system at the depth of the cortex was in the of range 3 to 6 mm, and the lateral image resolution at the depth of the neonatal cortex is estimated to be as good as 10 to 12 mm.
Conclusions: The HD-DOT system described is ultra-low weight, low profile, can conform to the infant scalp, and provides excellent imaging performance. It is expected that this device will make functional neuroimaging of the neonatal brain at the cot-side significantly more practical and effective.
We introduce a new wearable HD-DOT system that allows neuroimaging in naturalistic environments. Test results with visual paradigms show comparable performance to larger fiber-based systems.
We discuss advances in and applications of fibre-less, wearable, high-density diffuse optical tomography technologies, including a new device specifically for the newborn infant that employs flex-rigid PCB technology and provides channel density approaching 10 channels/cm2.
Burst suppression (BS) is an electroencephalographic state associated with a profound inactivation of the brain. BS and pathological discontinuous electroencephalography (EEG) are often observed in term-age infants with neurological injury and can be indicative of a poor outcome and lifelong disability. Little is known about the neurophysiological mechanisms of BS or how the condition relates to the functional state of the neonatal brain. We used simultaneous EEG and diffuse optical tomography (DOT) to investigate whether bursts of EEG activity in infants with hypoxic ischemic encephalopathy are associated with an observable cerebral hemodynamic response. We were able to identify significant changes in concentration of both oxy and deoxyhemoglobin that are temporally correlated with EEG bursts and present a relatively consistent morphology across six infants. Furthermore, DOT reveals patient-specific spatial distributions of this hemodynamic response that may be indicative of a complex pattern of cortical activation underlying discontinuous EEG activity that is not readily apparent in scalp EEG.
We present a method for acquiring whole-head images of changes in blood volume and oxygenation from the infant brain at cot-side using time-resolved diffuse optical tomography (TR-DOT). At UCL, we have built a portable TR-DOT device, known as MONSTIR II, which is capable of obtaining a whole-head (1024 channels) image sequence in 75 seconds. Datatypes extracted from the temporal point spread functions acquired by the system allow us to determine changes in absorption and reduced scattering coefficients within the interrogated tissue. This information can then be used to define clinically relevant measures, such as oxygen saturation, as well as to reconstruct images of relative changes in tissue chromophore concentration, notably those of oxy- and deoxyhaemoglobin. Additionally, the effective temporal resolution of our system is improved with spatio-temporal regularisation implemented through a Kalman filtering approach, allowing us to image transient haemodynamic changes. By using this filtering technique with intensity and mean time-of-flight datatypes, we have reconstructed images of changes in absorption and reduced scattering coefficients in a dynamic 2D phantom. These results demonstrate that MONSTIR II is capable of resolving slow changes in tissue optical properties within volumes that are comparable to the preterm head. Following this verification study, we are progressing to imaging a 3D dynamic phantom as well as the neonatal brain at cot-side. Our current study involves scanning healthy babies to demonstrate the quality of recordings we are able to achieve in this challenging patient population, with the eventual goal of imaging functional activation and seizures.
A quantitative comparison has been performed between two commercial near-infrared (NIR) vein-viewing systems which are designed to supplement the clinician’s traditional skills in locating veins by means of visualization and palpation. The AccuVein AV300 and Novarix IV-eye real-time imaging systems employ very different imaging geometries; the former generates an image from reflected NIR light produced by a beam scanned across the surface, while the latter illuminates the viewed region at four points on the periphery and records the resulting distribution of diffusely transmitted light. The comparison involved measuring the contrast produced by absorbing rods (simulated blood vessels) in a cylindrical phantom with tissue-like optical properties, and the contrast of superficial blood vessels in the arms of healthy volunteers. The locations and sizes of the blood vessels were independently verified using a clinical ultrasound imaging system. The phantom measurements suggested that the AV300 displays the most superficial vessels with greater contrast, but the IV-eye is able to detect vessels when they are at a depth up to 2 mm greater than the limit observed for the AV300. The results for thirty healthy volunteers also indicated that the AV300 typically displays vessels with higher overall contrast, but the effectiveness of the IV-eye at visualizing deeper vessels was even more pronounced, with a maximum depth several millimeters greater than that achieved by the AV300, and more than ten times as many vessels observed at depths below 4 mm.
An optical imaging system has been developed which uses measurements of diffusely reflected near-infrared light to
produce maps of changes in blood flow and oxygenation occurring within the cerebral cortex. Optical sources and
detectors are coupled to the head via an array of optical fibers, on a probe held in contact with the scalp, and data is
collected at a rate of 10 Hz. A clinical electroencephalography (EEG) system has been integrated with the optical system
to enable simultaneous observation of electrical and hemodynamic activity in the cortex of neurologically compromised
newborn infants diagnosed with seizures. Studies have made a potentially critically important discovery of previously
unknown transient hemodynamic events in infants treated with anticonvulsant medication. We observed repeated
episodes of small increases in cortical oxyhemoglobin concentration followed by a profound decrease in 3 of 4 infants
studied, each with cerebral injury who presented with neonatal seizures. This was not accompanied by clinical or EEG
seizure activity and was not present in nineteen matched controls. The underlying cause of these changes is currently
unknown. We tentatively suggest that our results may be associated with a phenomenon known as cortical spreading
depolarization, not previously observed in the infant brain.
We present preliminary data from an imaging system based on LED illumination for obtaining sequential multispectral
optical images of the human ocular fundus. The system is capable of acquiring images at speeds of up
to 20fps and we have demonstrated that the system is fast enough to allow images to be acquired with minimal
inter-frame movement. Further improvements have been identified that will improve both imaging speed and
image quality. The long-term goal is to use the system in conjunction with novel image analysis algorithms to
extract chromophore concentrations from images of the ocular fundus, with a particular emphasis on age-related
macular degeneration. The system has also found utility in fluorescence microscopy.
Optical tomography is a medical imaging technique which can provide images of haemodynamic parameters and oxygenation at the bedside. Here, we examine two approaches to optical tomography which are intended to provide information about perinatal brain injury. First, we reconstruct static 3D images showing the increase in blood volume and decrease in oxygenation associated with intra-ventricular haemorrhage. Second, we present the first 3D optical tomography images of the whole head during motor evoked responses and show that the peak of activation can be localised to within 11 mm of the estimated position of the motor cortex.
A method has been devised for generating three-dimensional optical images of the breast using a 32-channel time-resolved system and a liquid-coupled interface. The breast is placed in a hemispherical cup surrounded by sources and detectors, and the remaining space is filled with a fluid with tissue-like optical properties. This approach has three significant benefits. First, cups can accommodate a large range of breast sizes, enabling the entire volume of the breast to be sampled. Second, the coupling of the source and detector optics at the surface is constant and independent of the subject, enabling intensity measurements to be employed in the image reconstruction. Third, the external geometry of the reconstructed volume is known exactly. Images of isolated targets with contrasting absorbing and scattering properties have been acquired, and the performance of the system has been evaluated in terms of the contrast, spatial resolution, and localization accuracy. These parameters were strongly dependent on the location of the targets within the imaged volume. Preliminary images of a healthy human subject are also presented, which reveal subtle heterogeneity, particularly in the distribution of scatter. The ability to detect an absorbing target adjacent to the breast is also demonstrated.
We present a multi-dimensional TCSPC technique that combines multi-detector and multiplexing capability, and records fast and virtually unlimited sequences of time-of-flight distributions. The system consists of four fully parallel TCSPC channels. Each channel records simultaneously in up to eight detection channels. Up to four lasers and 32 source positions can be multiplexed. The total count rate is up to 4 x 107 photons per second. Time-of-flight sequences can be recorded with a resolution of 50 to 100 ms per curve. The system is operated within a single personal computer.
Optical tomography is being developed at UCL as a tool for understanding the mechanisms of haemorrhagic and hypoxic-ischaemic brain injury and assessing the effectiveness of novel neural rescue therapies in the newborn infant. Our 32-channel time-resolved optical imaging system measures photon flight times between multiple pairs of points on the surface of the head, and images sensitive to local variation in tissue absorption and scattering properties are reconstructed using non-linear algorithms. Several studies have been performed on premature infants using custom-built helmets, which hold up to 32 sources and detectors in contact with the head. Simulations have revealed that combining data with reference measurements acquired on a homogeneous object using the same fibre locations can significantly reduce errors in reconstructions due to uncertainty in the location of the sources and detectors. To provide the reference data, a homogeneous phantom based on a balloon filled with a scattering fluid of precisely known optical properties was made and inserted into the helmet immediately following each infant scan. In this paper, we evaluate the effectiveness of this approach by acquiring data on a realistically head-shaped phantom containing a small perturbation, and reconstructing it using the homogeneous head-shaped phantom and the fluid-filled balloon.
Near Infrared Spectroscopy (NIRS) is a powerful method for non-invasive mapping of cerebral functional activation. We have developed an NIRS instrument that is portable, inexpensive and lightweight consisting of an array of light emitting diodes (LEDs) and photodiodes (PDs) mounted on a flexible printed circuit board (PCB). The flexibility and portability of the instrument makes it easy to apply to subjects ranging from premature babies in intensive care to adults. The flexible PCB array consists of 48 LEDs operating at two different wavelengths (780nm & 880nm) together with 14 photodiodes. Transimpedence amplifiers for each of the PDs are located on the flexible pad to minimise noise pick up. The LEDs are pulsed (10ms) at a peak optical power of 20mW, while a sample and hold circuit monitors the voltages at all of the PDs. The array is also encapsulated in black silicon rubber, except for the regions directly above the LED's and PD's, which have a clear silicone rubber cover. The sensor array is attached to the electronics by two one metre long flexible ribbon cables. The monitoring circuit provides medical grade electrical isolation between the patient and computer. Studies have been conducted on phantoms to test the penetration depth of the sensor array for two different separations of LEDs and PDs (11mm and 27mm). The maximum depths that can be probed are 5mm and 11mm respectively. This makes it suitable for studying cortical activation in babies.
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